Retinopathy of Prematurity

Definition

Retinopathy of prematurity occurs primarily, but not exclusively, in premature infants. It refers to damage to the blood vessels of the developing eye.

Description

Retinopathy of Prematurity (ROP) was first diagnosed in 1942. This disease was prevalent among infants in hospital nurseries throughout the early 50's. ROP is a disease that affects the retina of the eye and can cause blindness. In 1956, a research study found that premature infants who breathed oxygen higher than 50 percent in concentration had three times the risk of developing ROP.

Causes

The factors that cause ROP and determine the outcome are not fully known, but prematurity and the degree of retinal immaturity at birth are major factors. Hyperoxia (high oxygen levels) is also a major factor, but other problems, including respiratory distress, heart disease, infection and anemia may be contributory factors. In general, the lower the birth weight and the more unhealthy the infant, the greater the risk of ROP. It is now known that oxygen alone is neither sufficient nor necessary to produce ROP, and no safe level of oxygen has yet been determined.

Diagnosis

An ophthalmologic examination of infants at risk is recommended.

Treatment

In more than 90 percent of all infants, there is spontaneous improvement of the disease process with little or no visual disability. Less than 10 percent of all infants progress toward a severe disease that can impair vision. At-risk infants benefit from maintaining blood level of vitamin E in the normal range. In selected cases, surgery is needed. Cryotherapy (gentle freezing) of the retina can reduce more severe complications. Laser surgery is now being used more frequently.

The best prevention is prenatal care that reduces the amount of prematurity.

Questions

What test is performed on a premature baby to diagnose retinopathy?

What are the side effects or risks of the test?

Will the test tell how much damage has been done?

If there is damage to the blood vessels or retina, is it permanent or reversible?

What treatment is given to correct the problem if it exists?

What are the chances of visual problems showing up later?

Some researchers have recommended the use of supplemental vitamin E for antioxidant properties, but its efficiency has not been proven.